The Effect of Successful Surgical Alignment on Improvement of Binocular Vision in Adults with Childhood Strabismus

To evaluate the effect of successful surgical alignment on improvement of binocular vision in adults with childhood strabismus In a prospective interventional study, consecutive patients with childhood-onset, comitant, horizontal and constant strabismus who had successful postoperative alignment were enrolled. Preoperative and postoperative binocular vision testing was performed using the Bagolini striated lenses and the Worths 4-Dot test. Improvement of binocular vision was defined as conversion of suppression to fusion response in Bagolini test and conversion of suppression to fusion or monofixation response in Worth 4-Dot test at three months after surgery. A total of 34 patients (15 females and 19 males) were included. The mean age at the time of surgery was 26.08±10.53 years (range, 14-53 years). The mean angel of deviation was 40.29±14.35 prism diopter (range, 20-75 prism diopter). Binocular vision was improved in 20 of 34 patients (58.8%) in Bagolini test. Also, binocular vision was improved in 20 of 34 patients (58.8%) in Worth 4-Dot test. There was no significant correlation between duration of misalignment and sensory outcome (p=0.67). There was a statistically insignificant increase in improvement of binocular vision in exotropic group (65%) compared with esotropic group (50%) (p=0.48). Also, there was a statistically insignificant increase in improvement of binocular vision in nonamblyopic group (60.8%) compared with amblyopic group (54.5%) (p=0.5). The angel of preoperative deviation had no influence on improvement of binocular vision (p=0.08). Surgical realignment leads to improvements in binocular vision in 58.8% of adults with childhood strabismus regardless of the type and angle of preoperative deviation, duration of strabismus, or amblyopia.